Warning: Montana Medicaid expansion may be hazardous for your health

"If a(n insurance) mandate was the solution, we could try that to solve homelessness by mandating everybody buy a house." — Sen. Barack Obama, 2007.

Growing up in a Montana family of 14, my parents taught us most important life lessons. One lesson driven home repeatedly: If a deal sounds too good to be true, it probably is. Such is the Obamacare deal. Everybody will be forced to buy health insurance … and that will magically mean better health care.

Obamacare's Medicaid component is particularly egregious for Montanans. They're going to vastly dis-incentivize anyone becoming a doctor, or continuing as a doctor, by greatly increasing their patient work load, telling them they must charge less for various treatments, and interjecting the federal bureaucracy between doctor and patient so doctors can't prescribe their best preferred, individualized treatment, but can only do what Medicaid pays for. They're going to "steer" 1 in 4 Americans onto a broken Medicaid system which was designed only to provide stopgap emergency care to the poorest among us, and they expect health care to improve? Especially in rural Montana which already has a doctor shortage and problems attracting new doctors? If you believe that, I've got ocean-front property in Ekalaka to sell you.

Hospitals, which made a devil's bargain in supporting Obamacare, will be aggressively pushing the Legislature for Montana Medicaid expansion — not because it means better health care for Montanans, but because it means better profits for hospitals. But here's what we already know about the poor quality of Medicaid. Recent studies reveal this startling fact — health outcomes for Medicaid patients are not only far worse than health outcomes for privately insured patients, sometimes they're even worse than outcomes for uninsured patients. Here's the data:

• Medicaid patients are seven times more likely to be rejected from a family physician than privately-insured patients. Only 53 percent of doctors say they accept new Medicaid patients. Obamacare will make health care access worse. (Center for Studying Health System Change, Health Tracking Physicians Survey)
• Surgical patients on Medicaid are 13 percent more likely to die than even uninsured patients and 97 percent more likely to die than privately insured patients. Patient Health Outcomes will be worse. (University of Virginia study)
• Individuals on Medicaid that have coronary artery bypass surgery are 50 percent more likely to die than patients with private coverage or Medicare. (Journal of the American College of Cardiology 2005)
• Medicaid cancer patients are two to three times more likely to pass away than other patients. (Journal Cancer 2005)

Please note the key fact — Medicaid patients are far more likely to die than even uninsured patients. And because Medicaid is means-tested, Montana's extremely low wages could result in up to 1 in 3 Montanans eventually steered onto this broken system, as the cost of private sector insurance skyrockets due to all the "wish-list" mandates liberal politicians crammed into Obamacare insurance. Obama's 2007 argument has been redoubled — Hey, let's not only force the homeless to buy a house, let's force them to buy a mansion. Result: Perhaps 1 in 3 Montanans will be priced out of private insurance and onto Medicaid.

And consider the enormous cost of Medicaid which will now be foisted on American taxpayers. By 2020, Medicaid will expand to cover 85 million Americans at a cost of $870 billion annually. As PJ O'Rourke forewarned us, "You think health care is expensive now. … Just wait and see how much it costs when it's free!"

Why did Montana's own Sen. Max Baucus, as finance chairman, design such a tragedy for Montanans, and why did Montana's Sen. Jon Tester cast the deciding vote in favor of it? D.C. politicians buy and sell deals "too good to be true" daily. Helena politicians should not follow suit. Medicaid expansion must be rejected — for better patient health and better taxpayer fiscal health. Stand up and make your voice heard in Helena.

(Joe Balyeat previously served as chairman of the Montana Senate committee overseeing health insurance mandates. He presently serves as state director of Americans For Prosperity/Montana and is a founding partner of the Montana Medical Free Choice Coalition.)